Rectal administration of d-alpha tocopherol for active ulcerative colitis: a preliminary report.
OBJECTIVE
To investigate the anti-oxidant and anti-neutrophil recruitment effects of rectal d-alpha (d-alpha) tocopherol administration on mild and moderately active ulcerative colitis (UC).


METHODS
Fifteen patients with mild and moderately active ulcerative colitis were enrolled in an open-label study of d-alpha tocopherol enema (8000 U/d) for 12 wk. All patients were receiving concomitant therapy with 5-aminosalicylic acid derivatives (5-ASA) and/or immunomodulator medications. Endoscopic evaluation was performed at baseline and after 4th and 12th weeks. Disease activity was measured with the Mayo disease activity index (DAI) and remission was defined as DAI of < or = 2 with no blood in stool. Clinical response was defined as a DAI reduction of > or = 2.


RESULTS
At the end of 12th week, the average DAI score significantly decreased compared to the beginning of the study (2.3 +/- 0.37 vs 8 +/- 0.48, P < 0.0001). One patient was withdrawn after 3 wk for being unavailable to follow-up. On the 4th week of therapy, 12 patients showed clinical response, 3 of whom (21.4%) achieving remission. After 12 wk, all 14 patients responded clinically to the therapy and remission was induced in 9 of them (64%). No patient reported adverse events or was hospitalized due to worsened disease activity.


CONCLUSIONS
This preliminary report suggests that rectal d-alpha tocopherol may represent a novel therapy for mild and moderately active UC. The observed results might be due to the anti-inflammatory and anti-oxidative properties of vitamin E.
Mirbagheri
Seyed-Amir
SA
Department of Internal Medicine, Amir-Alam Hospital, Tehran 13145-784, Iran. mirbagherimd@yahoo.com
Nezami
Behtash-Ghazi
BG
Assa
Solmaz
S
Hajimahmoodi
Mannan
M
D000285:Administration, Rectal; D000328:Adult; D000975:Antioxidants / Q000008:administration & dosage* / Q000009:adverse effects; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004733:Enema; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D016896:Treatment Outcome; D024502:alpha-Tocopherol / Q000008:administration & dosage* / Q000009:adverse effects
D000975:Antioxidants; D024502:alpha-Tocopherol